Marc Hürzeler and Otto Zuhr will be your instructors throughout the entire course series. Björn Ludwig and Wolf Richter will serve as an additional guest instructor in Course Module 8.
Markus B. Hürzeler received his D.M.D. degree in 1984 from the University of Zürich. He was certified as a Periodontics Specialist by the Swiss Society of Periodontology in 1989 and as a Prosthodontics Specialist by the German Society of Prosthodontics in 1991. He spent two years at the University of the Houston, Texas, Dental Branch as a Visiting Associate Professor in the Department of Periodontology from 1991-1993. After returning to Freiburg, Germany, he obtained the Docent (PhD) degree from the Department of Prosthodontics at Albert-Ludwigs University in Freiburg, Germany in 1996. He then moved to Munich, where he has since operated a joint private practice together with Dr. Otto Zuhr, limiting his activity to periodontics and implant dentistry. In 2002, he was appointed Professor of Dentistry at the Department of Medicine of Albert-Ludwigs University in Freiburg, Germany. In 2008, he co-founded the Hürzeler/Zuhr Education Center together with Dr. Zuhr, where they teach the concepts and philosophy of state-of-the-art dentistry. Markus B. Hürzeler has been a Clinical Associate Professor at the University of Texas in Houston since 1993, and an Associate Professor at the Albert-Ludwigs University Department of Preventive Dentistry and Periodontology in Freiburg Germany since 1997.
Professor Hürzeler is the president of the European Academy of Esthetic Dentistry (EAED). He has produced more than 150 scientific publications in the field of implant dentistry, periodontology, and tissue regeneration. He regularly gives lectures and courses on topics related to periodontics and implant dentistry at national and international events. In 2012, Markus B. Hürzeler and Otto Zuhr published the world renowned book “Plastic-Esthetic Periodontal and Implant Surgery - A Microsurgical Approach”.
Otto Zuhr studied dentistry at the University of Aachen from 1986 to 1992. He is board-certified specialist in Periodontology of the German Society of Periodontology (DGParo) and runs a private office together with Marc Hürzeler in Munich, Germany dedicated to periodontology and implant dentistry.
With more than 25 years of clinical experience and teaching practice, Dr. Zuhr has become a proven expert in his field well beyond the European borders. From 2007 to 2014 he was board member of the German Society of Periodontology (DGParo) and he`s presently holding an associate professorship position at the Department of Periodontology of the Johann-Wolfgang-Goethe University in Frankfurt/Main, Germany (Director: Prof. Peter Eickholz).
Otto Zuhr has written several refereed scientific articles in the field of periodontology and implant dentistry. His book “Plastic Esthetic Periodontal and Implant Surgery” was published by Quintessence in 2012. His research activities are focused on oral soft tissue wound healing and oral soft tissue reconstruction.
Dr. Wolf Richter studied dentistry at the university of Bonn where he graduated in 1986. During the following 3 years and even before opening up his own dental office in Munich in 1990, he set up the base for his endodontic knowledge throughout repeated participations in clinical trainings given by Frank Wein and Peter Guldener. Initiated by that, his prior interest for endodontics kept steadily growing in the aftermath and resulted in the installation of the first surgical microscope into the office. His succeeding primary dedication to mere endodontic treatments followed subsequently as a logic professional step. From 1997 on, his professional development therefore involved several clinical traineeships with S. Kim and C. Ruddle in the United States.
Since 1997 Dr Wolf Richter has thereby become a frequently asked teacher in the field of microsurgical endodontic treatments by himself within the frame of his own course programme.
In the year of 2000, Dr Wolf Richter finally launched his own private practice in Munich. Two years later, he was one of the founding members of the German Association of Endodontics (DGET) for which he officiated twice as a chairman during the following years (2002-2005 and 2006-2007). From 2002 to 2009 Dr Wolf Richter was teaching in cooperation with Dr Josef Diemer at the Institute for Periodontology and Implantology focusing on the conventional and surgical endodontic skill set.
In 2005, Dr Wolf Richter was appointed to an EDA-Specialist for Endodontics. Since 2006, he has been lecturing in the course of the DGET-Curriculum and has been deputized as a DGET-specialist in 2007. From 2011-2017 he was lecturing in the master programme of the Dusseldorf Dental Academy (DDA).
Björn Ludwig maintains a private orthodontic practice in Traben-Trarbach, Germany. He is Assistant Professor at the University of Homburg/Saar, Department of Orthodontics. His focus of research work is skelettal anchorage and 3D imaging. He has published more than 100 peer reviewed clinical and scientific articles, and is editor of three books. He is editor in chief of the Quintessenz publication "Kieferorthopädie" (Orthodontics). He is also co-editor of the Journal of Clinical Orthodontics. He is active member of the Angle society of Europe and serves in the council of the German board in Orthodontics. He is the current president of the European Begg Society.
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From the contemporary practice perspective, dogmatically rigid treatment concepts and fixed routine practice procedures cannot satisfy these demands. Therefore, apart from merely giving participants the technical skills needed to perform the necessary medical interventions and surgical procedures, modern continuing medical education and training programs must also ensure that participants have the solid knowledge base needed for sound decision-making in each individual patient’s case.
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Participants taking the entire master class series receive a €150 discount per course, regardless of the order of completion of the modules and the time between courses. Participants who complete all eight Hürzeler/Zuhr Master Classes will be awarded the title of Hürzeler/Zuhr Master Clinician of Periodontology and Implant Therapy, stamped with the seal of the Wolfgang Goethe University of Frankfurt/Main. Hürzeler/Zuhr Master Weeks were especially designed to accommodate participants who have to travel long distances to the course venue. Two of the eight Hürzeler / Zuhr Master Classes are covered in each of the four Hürzeler/Zuhr Master Weeks.
Live surgery sessions, lectures and, most importantly, practical training on different types of models are the main focus of our training classes.
Our three-day classes are offered on a work-friendly schedule (Thursday afternoon to Saturday evening) and are co-supervised by both instructors (Prof. Dr. Hürzeler and Dr. Zuhr) to ensure that the participants receive intensive support.
Classes can be booked individually or in series and are suitable for both the novice and seasoned clinician. English is the language of instruction. Videos of the live surgeries will be made available to the participants 14 days after each course.
- MC 1: Microsurgical Training
SummaryHigh-power magnification requiring a surgical microscope is rarely necessary in the oral surgical procedures performed today. The dimensions of most standard microsurgical instruments and sutures, particularly those used in periodontal and implant surgery, require only 4.5X to 6X magnification. Therefore, standard loupe systems provide sufficient magnification in the majority of cases.
In view of this, why should you take a three-day course devoted exclusively to surgery under the microscope using magnifying powers as high as 20X?
The answer is simple: This course module will boost the success of your future surgical work because the fact that successful surgical outcomes are largely dependent on the manual skills of the individual surgeon has not changed. Regardless of your current level, this course will push you to your limits, thereby providing exactly the right impetus you need to effectively and sustainably train and enhance your manual skills. During these three days of training, you will build the foundation needed to successfully complete all of the remaining Hürzeler/Zuhr Master Classes.
Contents:
- Oral soft-tissue wound healing, flap design, microsurgical suturing techniques
Hands-on Training:
- Incision design, flap preparation, flap mobilization and flap stabilization
- End-to-end anastomosis of the greater palatine artery in pig jaws
- MC 2: Access and Regenerative Periodontal Surgery
SummarySurgical interventions are only a small piece of the jigsaw puzzle for the successful management of patients with periodontal disease. In other words, even if executed using best practices and techniques, periodontal surgery procedures will not have a significant impact if they are not embedded in a practice environment that ensures that all the necessary phases of systematic periodontal treatment can be carried out in a competent manner.
This course does not dispense with the need to study the fundamentals of periodontology. However, the first part of this course module will teach you the most important theoretical aspects of establishing the structured approach needed for the systematic management of periodontal disease patients in private practice. Moreover, you will learn strategies for systematic treatment planning and indications for various periodontal surgical interventions required to achieve defined treatment goals according to established treatment concepts based on case studies in interactive work group discussions.
During these three days of training, you will focus on learning the microsurgical flap techniques needed, in particular, to perform regenerative periodontal surgery procedures. Intensive hands-on training with various training models and live surgeries will help you become skilled at planning and executing incision design, flap elevation, flap mobilization and flap stabilization techniques with a defect-specific approach. The skills learned in this course, up to an including the treatment of so-called hopeless teeth, will give you the foundation needed to manage patients with periodontal disease even more successfully in the future.
Contents
- Examination and diagnosis of patients with periodontal diseases
- Treatment planning protocols for patients with periodontal diseases
- Systematic periodontal therapy
- Surgical access therapy
- Regenerative periodontal therapy
- Max out periodontal therapy and hopeless teeth
Hands-on Training
- Treatment planning
- Microsurgical access flap
- Regenerative periodontal therapy for intrabony and class II furcation defects
- Decision-making in regenerative periodontal therapy
Live Surgeries
- Periodontal surgery I: Access therapy
- Periodontal surgery II: Regenerative therapy
- MC 3: Resective Periodontal Surgery
SummaryIs there still room for resective periodontal procedures in the era of minimally invasive dentistry? The clear answer is: Yes, there is!
Within the scope of modern periodontal therapy, pocket elimination can still make sense in areas outside the esthetic zone if periodontal regeneration is not possible. Classical interventions like tunneling procedures, root amputation or hemisection have not died out but are still used to treat furcation-involved molars. In fact, not that it is becoming more and more evident that patients with a history of periodontitis have an increased risk of developing peri-implant diseases, these techniques are undergoing a renaissance and are more current than ever. Last but not least: up to date restorative dentistry would not be imaginable without resective periodontal surgery in situations where subgingival restoration margins cannot be managed by other methods. Fortunately, the radical approaches used in the 1960s and 1970s do not have much in common with the state-of-the art techniques performed today.
A contemporary approach to periodontal surgery with minimal damage to tissues and fibers will be the center of attention in these three days. Key elements include the sharing of important periodontal background knowledge and meticulous hands-on training.
Contents
- Indications and contemporary procedures
- Elimination of subgingival restoration margins
- Elimination of remaining pockets
- Treatment of furcation-involved molars
- Fiber retention technique
Hands-on Training
- Minimally invasive apically repositioned flaps I: Upper jaw – tuberoplasty
- Minimally invasive apically repositioned flaps II: Lower jaw – distal wedge technique
- Root resective periodontal surgery
Live Surgeries
- Minimally invasive apically repositioned flaps I: Upper jaw
- Minimally invasive apically repositioned flaps II: Lower jaw
- MC 4: Cutting Edge Implant Therapy – The Essence of New Methods
SummaryFew innovations over the last 50 years have changed dentistry as much as the introduction of dental implants to replace lost or missing teeth. Modern dental treatment concepts without implants are hardly conceivable today. Still, it is becoming increasingly clear that implant dentistry will face major challenges in the next few years: Although reports of high medium-term survival rates initially made it appear that osseointegrated implants would remain in the patient's mouth for a lifetime in most cases, current cross-sectional studies have changed that outlook. A significant proportion of implant patients are clearly at risk of developing long-term biological complications in the form of peri-implant disease, including peri-implant mucositis and peri-implantitis. These are serious problems as hardly any predictable, scientific evidence-based, tried-and-tested treatments are currently available. Against this background, there appears to be an urgent need for extensive rethinking.
More than ever before, implant manufacturers are under enormous pressure to innovate in order to survive in a highly competitive market. The importance of critically scrutinizing supposed advances and innovations cannot be stressed enough, especially with regard to their possible long-term biological complications. Past research and training in implant dentistry often focused on technical aspects, such as cutting, drilling and screw insertion. In the future, it will be helpful to remember some of the benefits of past dental standards and practices while striving to develop sustainable strategies that ensure the complication-free management of dental implant patients so as to reliably prevent implant loss over the years, in spite of increasing life expectancy.
Another clear scientific trend today is that patient reviews are increasingly becoming the instrument by which medical interventions, treatment protocols, and treatment outcomes are rated, particularly in terms of morbidity and cost-benefit ratio. Although implant dentistry has had some success in recent years, there is still a lot of catching up to do. In particular, there is a need develop treatment protocols that result in fewer surgical procedures, shorter treatment times and less treatment complexity for the benefit of the patient.
Based on this premise, we will try to shine some light in the jungle of supposed advances in implantology in the scope of this course module. In interactive discussions and group activities, we examine the latest advances in implantology together with course participants in order to identify and discuss in detail those that can truly improve treatment outcomes in dental implant patients. These activities will focus on digital technologies and their potential to make dental implant treatment protocols safer, more predictable and, above all, simpler for patients.
The prevention, diagnosis and treatment of peri-implant diseases are the central themes of this three-day course. Based on the guiding principle of biologically driven implant placement, we will discuss clinical issues which, from today's perspective, must be taken into account in dental implant planning and treatment for optimal prevention of peri-implant diseases in the future. Participants will focus on learning surgical techniques for establishing sufficiently thick keratinized and fixed peri-implant mucosa in a wide range of clinical situations in well-supervised hands-on training exercises and live surgeries.
Contents
- Requirements for long-term success with implant-supported restorations
- Peri-implant disease: prevention, diagnosis and treatment of peri-implant lesions
- Composition of the peri-implant mucosa / impacts on peri-implant disease prevention
- Implant therapy and digital dentistry
- Current trends / implant patients and patient-reported outcome measures
- Timing of implant placement / immediate implant placement in the posterior dentition
Practical Training
- Implant uncovering in non-esthetic sites I: Increasing mucosal thickness
- Implant uncovering in non-esthetic sites II: Increasing the width of keratinized mucosa
- Immediate implant placement, immediate impressions and immediate provisionalization in the posterior dentition
Live Surgeries
- Implant uncovering in non-esthetic sites
- Immediate implant placement, immediate impressions and immediate provisionalization in the posterior dentition
- MC 5: Periodontal Plastic Surgery
SummaryReconstructing soft-tissue defects in the esthetic zone is highly challenging for any clinician. For many years, the scientific and clinical development of suitable surgical techniques was measured in terms of achieving the best quantitative results possible. In the current view, however, it is impossible to obtain successful treatment outcomes if the best defect augmentation possible does not go hand-in-hand with good qualitative results in terms of color, surface texture and scar tissue. Therefore, even small shortcomings of the surgical procedure could lead to problems that can hardly be corrected later in many cases.
During these three days of training, course participants will further develop surgical skills learned in the previous modules. Theoretical and practical aspects of gingival recession management comprise the main course contents. Clinical experience in this field dates back several decades and is substantiated by an excellent base of scientific evidence. The previous training courses have given you the surgical skills and knowledge of biological principles underlying the treatment of gingival recession needed to ensure that you have a solid basis for performing more sophisticated techniques of soft-tissue reconstruction around teeth, implants and pontics presented in the more advanced modules.
Contents
- Oral soft-tissue esthetics – criteria and guidelines
- Soft tissue grafting – autografts and substitute biomaterials
- Gingival recession management
Practical Training
- Soft-tissue autograft harvesting from the anterior and posterior palate / single incision, trap door and distal wedge techniques
- Gingival recession management I: Modified coronally advanced flap
- Gingival recession management II: Modified coronally advanced tunnel flap
- Gingival recession management III: Double pedicle flap
Live Surgeries
- Gingival recession management I: Modified coronally advanced flap
- Gingival recession management II; Modified coronally advanced tunnel flap
- MC 6: Implant Therapy in the Esthetic Zone
SummaryThe use of implants for tooth replacement in the esthetic zone is still an enormous challenge in practice. The clinician must consider a wide range of different concepts and approaches, not to mention the controversy and disagreement in the literature surrounding the overabundance of different macro and micro implant configurations and wide range of different hard and soft-tissue replacement materials for the maintenance and stabilization of peri-implant tissues. In particular, there still is no conclusive answer to the question of which treatment protocol is more predictable: immediate implant placement while preserving as much peri-implant tissue as possible or delayed implant placement with the best possible reconstruction of missing hard and soft-tissue structures. For the clinician, treatment decision-making for each individual patient’s case is often challenging, especially in view of the growing awareness that not only complete quantitative defect reconstruction but also qualitative esthetic results are key to achieving successful treatment outcomes.
This three-day seminar provides in-depth instruction in the essential scientific background information required to have the knowledge base needed to make the right decisions in the individual case for the benefit of your patients. Well-supervised hands-on training and carefully selected live surgeries will help you to effectively practice and internalize the essential clinical steps involved in immediate implant placement with alveolar ridge prophylaxis and in delayed or late implant placement with tissue reconstruction according to the current rules of practice.
Contents
- Biology and healing of extraction sockets
- Alveolar ridge preservation techniques
- Immediate implant placement
- Delayed implant placement
- Peri-implant soft-tissue deficiencies
Hands-on Training
- Delayed implant placement with hard and soft-tissue augmentation
- Implant uncovering with soft-tissue reconstruction
Live Surgeries
- Immediate implant placement with alveolar ridge preservation
- Delayed implant placement with hard and soft-tissue reconstruction
- Implant uncovering with soft-tissue reconstruction
- MC 7: Advanced Hard Tissue Defect Reconstruction
SummaryDental implant treatments can reach the limits of what is feasible for everyone involved in cases where tooth loss is associated with large-volume bone defects, especially in the vertical direction. Except for sinus floor elevation, most procedures for the surgical reconstruction of such hard-tissue defects have a relatively poor base of scientific evidence substantiating their predictability and long-term stability. Consequently, they are frequently associated with substantial morbidity for the affected patients. When these defects are located in highly esthetic areas, it is very rarely possible to achieve a truly predictable esthetic outcome. Last but not least, proper execution of the available surgical procedures requires a high level of manual dexterity on the part of the surgeon.
In this course module, we will therefore review the currently available literature together with the participants in order to identify procedures that satisfy today's requirements for successful bone reconstruction. In doing so, we will realistically define what each available procedure can actually be expected to achieve in specific indications as well as their weaknesses and limitations. During these three days of intensive and systematic training, you will focus on practicing these techniques on various training models. Live surgeries are also included to enable you to successfully carry out these procedures on your own patients directly after course completion.
Contents
- Bone healing and defect morphology
- Barriers, bone grafts and bone substitutes
- Sinus floor elevation with a lateral and crestal approach
- Bone augmentation procedures/ distraction osteogenesis, sandwich technique, cortical bone plate method
- Complication management
Hands-on Training
- Sinus floor elevation with a lateral approach
- Vertical bone augmentation with the cortical bone plate method
Live Surgeries
- Sinus floor elevation with a lateral approach
- Vertical bone augmentation with the cortical bone plate method
- MC 8: Interdisciplinary Approaches
SummaryPeriodontal and peri-implant surgical interventions are only small pieces of a comprehensive jigsaw puzzle when it comes to successfully addressing complex and individual patient demands in daily clinical routine. Managing the interfaces between periodontology and implant therapy as well as neighboring disciplines such as prosthetics, orthodontics, endodontic treatment, restorative dentistry and maxillofacial surgery is undoubtedly one of the biggest challenges in modern dentistry today.
For this reason, this module is dedicated to surgical procedures at the border to other dental disciplines, like orthodontic implant placement or gingival augmentation before and after orthodontic treatment, pontic site development or esthetic crown lengthening before prosthetic treatment or papilla reconstruction in combination with restorative dentistry. Furthermore, it will touch on important connections, for example, endo-perio lesions, gingival alignment and defect augmentation by orthodontic tooth movement, closure of black triangles with interdental composite restorations after periodontal therapy, prosthetic concepts in periodontally compromised dentitions and, most importantly, sustainable strategies during regular maintenance care. Last but not least, this course is about communication, timing, treatment planning and team-building as the final steps towards becoming a true master clinician in periodontology and implant dentistry.
Contents
- Orthodontic tooth movement in periodontally compromised patients
- Gingival augmentation before and after orthodontic treatment
- Ridge augmentation by orthodontic tooth movement
- Gingival alignment by orthodontic tooth movement
- Implants used for orthodontic anchorage
- Treatment of perio-endo lesions
- Esthetic crown lengthening
- Pontic site development
- Papilla reconstruction and restorative compensation of missing interdental tissues
- Synergistic cooperation with dental hygiene staff
Hands-on Training
- Comprehensive treatment planning
- Esthetic crown lengthening
- Surgical papilla reconstruction
- Master Week 1 (MC 1+2):MC 1: Microsurgical TrainingSummary
High-power magnification requiring a surgical microscope is rarely necessary in the oral surgical procedures performed today. The dimensions of most standard microsurgical instruments and sutures, particularly those used in periodontal and implant surgery, require only 4.5X to 6X magnification. Therefore, standard loupe systems provide sufficient magnification in the majority of cases.
In view of this, why should you take a three-day course devoted exclusively to surgery under the microscope using magnifying powers as high as 20X?
The answer is simple: This course module will boost the success of your future surgical work because the fact that successful surgical outcomes are largely dependent on the manual skills of the individual surgeon has not changed. Regardless of your current level, this course will push you to your limits, thereby providing exactly the right impetus you need to effectively and sustainably train and enhance your manual skills. During these three days of training, you will build the foundation needed to successfully complete all of the remaining Hürzeler/Zuhr Master Classes.
Contents:
- Oral soft-tissue wound healing, flap design, microsurgical suturing techniques
Hands-on Training:
- Incision design, flap preparation, flap mobilization and flap stabilization
- End-to-end anastomosis of the greater palatine artery in pig jaws
MC 2: Access and Regenerative Periodontal SurgerySummarySurgical interventions are only a small piece of the jigsaw puzzle for the successful management of patients with periodontal disease. In other words, even if executed using best practices and techniques, periodontal surgery procedures will not have a significant impact if they are not embedded in a practice environment that ensures that all the necessary phases of systematic periodontal treatment can be carried out in a competent manner.
This course does not dispense with the need to study the fundamentals of periodontology. However, the first part of this course module will teach you the most important theoretical aspects of establishing the structured approach needed for the systematic management of periodontal disease patients in private practice. Moreover, you will learn strategies for systematic treatment planning and indications for various periodontal surgical interventions required to achieve defined treatment goals according to established treatment concepts based on case studies in interactive work group discussions.
During these three days of training, you will focus on learning the microsurgical flap techniques needed, in particular, to perform regenerative periodontal surgery procedures. Intensive hands-on training with various training models and live surgeries will help you become skilled at planning and executing incision design, flap elevation, flap mobilization and flap stabilization techniques with a defect-specific approach. The skills learned in this course, up to an including the treatment of so-called hopeless teeth, will give you the foundation needed to manage patients with periodontal disease even more successfully in the future.
Contents
- Examination and diagnosis of patients with periodontal diseases
- Treatment planning protocols for patients with periodontal diseases
- Systematic periodontal therapy
- Surgical access therapy
- Regenerative periodontal therapy
- Max out periodontal therapy and hopeless teeth
Hands-on Training
- Treatment planning
- Microsurgical access flap
- Regenerative periodontal therapy for intrabony and class II furcation defects
- Decision-making in regenerative periodontal therapy
Live Surgeries
- Periodontal surgery I: Access therapy
- Periodontal surgery II: Regenerative therapy
- Master Week 2 (MC 3+4):MC 3: Resective Periodontal SurgerySummary
Is there still room for resective periodontal procedures in the era of minimally invasive dentistry? The clear answer is: Yes, there is!
Within the scope of modern periodontal therapy, pocket elimination can still make sense in areas outside the esthetic zone if periodontal regeneration is not possible. Classical interventions like tunneling procedures, root amputation or hemisection have not died out but are still used to treat furcation-involved molars. In fact, not that it is becoming more and more evident that patients with a history of periodontitis have an increased risk of developing peri-implant diseases, these techniques are undergoing a renaissance and are more current than ever. Last but not least: up to date restorative dentistry would not be imaginable without resective periodontal surgery in situations where subgingival restoration margins cannot be managed by other methods. Fortunately, the radical approaches used in the 1960s and 1970s do not have much in common with the state-of-the art techniques performed today.
A contemporary approach to periodontal surgery with minimal damage to tissues and fibers will be the center of attention in these three days. Key elements include the sharing of important periodontal background knowledge and meticulous hands-on training.
Contents
- Indications and contemporary procedures
- Elimination of subgingival restoration margins
- Elimination of remaining pockets
- Treatment of furcation-involved molars
- Fiber retention technique
Hands-on Training
- Minimally invasive apically repositioned flaps I: Upper jaw – tuberoplasty
- Minimally invasive apically repositioned flaps II: Lower jaw – distal wedge technique
- Root resective periodontal surgery
Live Surgeries
- Minimally invasive apically repositioned flaps I: Upper jaw
- Minimally invasive apically repositioned flaps II: Lower jaw
MC 4: Cutting Edge Implant Therapy – The Essence of New MethodsSummaryFew innovations over the last 50 years have changed dentistry as much as the introduction of dental implants to replace lost or missing teeth. Modern dental treatment concepts without implants are hardly conceivable today. Still, it is becoming increasingly clear that implant dentistry will face major challenges in the next few years: Although reports of high medium-term survival rates initially made it appear that osseointegrated implants would remain in the patient's mouth for a lifetime in most cases, current cross-sectional studies have changed that outlook. A significant proportion of implant patients are clearly at risk of developing long-term biological complications in the form of peri-implant disease, including peri-implant mucositis and peri-implantitis. These are serious problems as hardly any predictable, scientific evidence-based, tried-and-tested treatments are currently available. Against this background, there appears to be an urgent need for extensive rethinking.
More than ever before, implant manufacturers are under enormous pressure to innovate in order to survive in a highly competitive market. The importance of critically scrutinizing supposed advances and innovations cannot be stressed enough, especially with regard to their possible long-term biological complications. Past research and training in implant dentistry often focused on technical aspects, such as cutting, drilling and screw insertion. In the future, it will be helpful to remember some of the benefits of past dental standards and practices while striving to develop sustainable strategies that ensure the complication-free management of dental implant patients so as to reliably prevent implant loss over the years, in spite of increasing life expectancy.
Another clear scientific trend today is that patient reviews are increasingly becoming the instrument by which medical interventions, treatment protocols, and treatment outcomes are rated, particularly in terms of morbidity and cost-benefit ratio. Although implant dentistry has had some success in recent years, there is still a lot of catching up to do. In particular, there is a need develop treatment protocols that result in fewer surgical procedures, shorter treatment times and less treatment complexity for the benefit of the patient.
Based on this premise, we will try to shine some light in the jungle of supposed advances in implantology in the scope of this course module. In interactive discussions and group activities, we examine the latest advances in implantology together with course participants in order to identify and discuss in detail those that can truly improve treatment outcomes in dental implant patients. These activities will focus on digital technologies and their potential to make dental implant treatment protocols safer, more predictable and, above all, simpler for patients.
The prevention, diagnosis and treatment of peri-implant diseases are the central themes of this three-day course. Based on the guiding principle of biologically driven implant placement, we will discuss clinical issues which, from today's perspective, must be taken into account in dental implant planning and treatment for optimal prevention of peri-implant diseases in the future. Participants will focus on learning surgical techniques for establishing sufficiently thick keratinized and fixed peri-implant mucosa in a wide range of clinical situations in well-supervised hands-on training exercises and live surgeries.
Contents
- Requirements for long-term success with implant-supported restorations
- Peri-implant disease: prevention, diagnosis and treatment of peri-implant lesions
- Composition of the peri-implant mucosa / impacts on peri-implant disease prevention
- Implant therapy and digital dentistry
- Current trends / implant patients and patient-reported outcome measures
- Timing of implant placement / immediate implant placement in the posterior dentition
Practical Training
- Implant uncovering in non-esthetic sites I: Increasing mucosal thickness
- Implant uncovering in non-esthetic sites II: Increasing the width of keratinized mucosa
- Immediate implant placement, immediate impressions and immediate provisionalization in the posterior dentition
Live Surgeries
- Implant uncovering in non-esthetic sites
- Immediate implant placement, immediate impressions and immediate provisionalization in the posterior dentition
- Master Week 3 (MC 5+6)MC 5: Periodontal Plastic SurgerySummary
Reconstructing soft-tissue defects in the esthetic zone is highly challenging for any clinician. For many years, the scientific and clinical development of suitable surgical techniques was measured in terms of achieving the best quantitative results possible. In the current view, however, it is impossible to obtain successful treatment outcomes if the best defect augmentation possible does not go hand-in-hand with good qualitative results in terms of color, surface texture and scar tissue. Therefore, even small shortcomings of the surgical procedure could lead to problems that can hardly be corrected later in many cases.
During these three days of training, course participants will further develop surgical skills learned in the previous modules. Theoretical and practical aspects of gingival recession management comprise the main course contents. Clinical experience in this field dates back several decades and is substantiated by an excellent base of scientific evidence. The previous training courses have given you the surgical skills and knowledge of biological principles underlying the treatment of gingival recession needed to ensure that you have a solid basis for performing more sophisticated techniques of soft-tissue reconstruction around teeth, implants and pontics presented in the more advanced modules.
Contents
- Oral soft-tissue esthetics – criteria and guidelines
- Soft tissue grafting – autografts and substitute biomaterials
- Gingival recession management
Practical Training
- Soft-tissue autograft harvesting from the anterior and posterior palate / single incision, trap door and distal wedge techniques
- Gingival recession management I: Modified coronally advanced flap
- Gingival recession management II: Modified coronally advanced tunnel flap
- Gingival recession management III: Double pedicle flap
Live Surgeries
- Gingival recession management I: Modified coronally advanced flap
- Gingival recession management II; Modified coronally advanced tunnel flap
MC 6: Implant Therapy in the Esthetic ZoneSummaryThe use of implants for tooth replacement in the esthetic zone is still an enormous challenge in practice. The clinician must consider a wide range of different concepts and approaches, not to mention the controversy and disagreement in the literature surrounding the overabundance of different macro and micro implant configurations and wide range of different hard and soft-tissue replacement materials for the maintenance and stabilization of peri-implant tissues. In particular, there still is no conclusive answer to the question of which treatment protocol is more predictable: immediate implant placement while preserving as much peri-implant tissue as possible or delayed implant placement with the best possible reconstruction of missing hard and soft-tissue structures. For the clinician, treatment decision-making for each individual patient’s case is often challenging, especially in view of the growing awareness that not only complete quantitative defect reconstruction but also qualitative esthetic results are key to achieving successful treatment outcomes.
This three-day seminar provides in-depth instruction in the essential scientific background information required to have the knowledge base needed to make the right decisions in the individual case for the benefit of your patients. Well-supervised hands-on training and carefully selected live surgeries will help you to effectively practice and internalize the essential clinical steps involved in immediate implant placement with alveolar ridge prophylaxis and in delayed or late implant placement with tissue reconstruction according to the current rules of practice.
Contents
- Biology and healing of extraction sockets
- Alveolar ridge preservation techniques
- Immediate implant placement
- Delayed implant placement
- Peri-implant soft-tissue deficiencies
Hands-on Training
- Delayed implant placement with hard and soft-tissue augmentation
- Implant uncovering with soft-tissue reconstruction
Live Surgeries
- Immediate implant placement with alveolar ridge preservation
- Delayed implant placement with hard and soft-tissue reconstruction
- Implant uncovering with soft-tissue reconstruction
- Master Week 4 (MC 7+8):MC 7: Advanced Hard Tissue Defect ReconstructionSummary
Dental implant treatments can reach the limits of what is feasible for everyone involved in cases where tooth loss is associated with large-volume bone defects, especially in the vertical direction. Except for sinus floor elevation, most procedures for the surgical reconstruction of such hard-tissue defects have a relatively poor base of scientific evidence substantiating their predictability and long-term stability. Consequently, they are frequently associated with substantial morbidity for the affected patients. When these defects are located in highly esthetic areas, it is very rarely possible to achieve a truly predictable esthetic outcome. Last but not least, proper execution of the available surgical procedures requires a high level of manual dexterity on the part of the surgeon.
In this course module, we will therefore review the currently available literature together with the participants in order to identify procedures that satisfy today's requirements for successful bone reconstruction. In doing so, we will realistically define what each available procedure can actually be expected to achieve in specific indications as well as their weaknesses and limitations. During these three days of intensive and systematic training, you will focus on practicing these techniques on various training models. Live surgeries are also included to enable you to successfully carry out these procedures on your own patients directly after course completion.
Contents
- Bone healing and defect morphology
- Barriers, bone grafts and bone substitutes
- Sinus floor elevation with a lateral and crestal approach
- Bone augmentation procedures/ distraction osteogenesis, sandwich technique, cortical bone plate method
- Complication management
Hands-on Training
- Sinus floor elevation with a lateral approach
- Vertical bone augmentation with the cortical bone plate method
Live Surgeries
- Sinus floor elevation with a lateral approach
- Vertical bone augmentation with the cortical bone plate method
MC 8: Interdisciplinary ApproachesSummaryPeriodontal and peri-implant surgical interventions are only small pieces of a comprehensive jigsaw puzzle when it comes to successfully addressing complex and individual patient demands in daily clinical routine. Managing the interfaces between periodontology and implant therapy as well as neighboring disciplines such as prosthetics, orthodontics, endodontic treatment, restorative dentistry and maxillofacial surgery is undoubtedly one of the biggest challenges in modern dentistry today.
For this reason, this module is dedicated to surgical procedures at the border to other dental disciplines, like orthodontic implant placement or gingival augmentation before and after orthodontic treatment, pontic site development or esthetic crown lengthening before prosthetic treatment or papilla reconstruction in combination with restorative dentistry. Furthermore, it will touch on important connections, for example, endo-perio lesions, gingival alignment and defect augmentation by orthodontic tooth movement, closure of black triangles with interdental composite restorations after periodontal therapy, prosthetic concepts in periodontally compromised dentitions and, most importantly, sustainable strategies during regular maintenance care. Last but not least, this course is about communication, timing, treatment planning and team-building as the final steps towards becoming a true master clinician in periodontology and implant dentistry.
Contents
- Orthodontic tooth movement in periodontally compromised patients
- Gingival augmentation before and after orthodontic treatment
- Ridge augmentation by orthodontic tooth movement
- Gingival alignment by orthodontic tooth movement
- Implants used for orthodontic anchorage
- Treatment of perio-endo lesions
- Esthetic crown lengthening
- Pontic site development
- Papilla reconstruction and restorative compensation of missing interdental tissues
- Synergistic cooperation with dental hygiene staff
Hands-on Training
- Comprehensive treatment planning
- Esthetic crown lengthening
- Surgical papilla reconstruction
- Special 1: Dental Hygiene Conceptions at the Interface of Periodontology and Implant Dentistry
SummaryThis course is designed to serve as an adjunctive program for Dental Hygienists working with Dentists that have taken the Hürzeler/Zuhr Academy course program. Its about opening up communication and focus on the team work approach of periodontal and implant therapies and calibrating the team with the patient in focus. This will help each practice team to develop treatment protocols in its own practice.
Anti-infective therapy is still the gold standard of nonsurgical treatment, we will be looking at what are our options. With practical and live demonstrations in introducing some of the newer instruments at our finger tips. Giving the participants the possibility of using specialized instruments for root planning and adaption into furcation areas. Air-abrasion powder will part of our focus in both SPT and Implant therapies. Giving participants time to practice and increase skill level, and watch our Hygienists use this treatment option in live demonstrations that will be interactive.
We as Dental Hygienist need to motivate our patients not only to follow through on treatment but also optimizing home care. Motivational Interviewing is a necessary skill to keep communication open not only with the patient but within the Team. We will be offering a small introduction into Motivational Interviewing with a team approach to home care protocols for your patients.This program will take all we learned in school and our life experience and tie it all together with the evidence and experience of our Team. Communication between Dentist and Hygienist is important for establishing a protocol so the whole team is onboard. Hopefully the participants will become a stronger voice in patient management.
Please bring Loupes if you have them with you for the Hands-on exercises.Subjects:
- calibrating the team, communication and establishing protocols
- anti-infective therapy and optionswith specialized instruments
- air abrasion powders
- supportive periodontal therapy, deciding intervals
- motivational interviewing to optimize home care
- patient care through all phases of treatment
- what are the limits? discussing treatment limitations in our individual settings
- implants and maintenance care, what is the evidence telling us?
Practical Trainings:
- root planning with specialized instruments, on models and extracted teeth
- air abrasion powders for supra and subgingival/submucosal uses, on models and extracted teeth
- implant therapies with titanium instruments and air-abrasion powder
Live Demonstrations:
- Subgingival scaling with furcation involvement (hand and power instruments)
- Air-abrasion powder in SPT appointments with localized Antibiotic treatment
- Implant therapies – Peri-Implant therapy and Mucositis therapy
- Special 2: Immediate Implant Placement with Partial Root Retention
SummarySubjects:
- biology and healing of extraction sockets
- alveolar ridge preservation techniques
- immediate implant placement
- partial root retention – indications and case selection
- the socket-shield technique – clinical course of action
- complication management
Practical Trainings:
- decoronation, root preparation and partial extraction socket management
- computer-guided immediate implant placement with partial root retention
- immediate provisionalization
Live Surgeries:
- immediate implant placement with partial root retention and immediate provisionalization
Summary:
It appears to be fundamental, that over the past two decades a clear paradigm shift within health care towards patient-centered care could be noticed. Based on this premise, immediate implant placement with shorter treatment time, less treatment effort and fewer surgical interventions has gained increasing attention in the recent past. While the survival rates of immediately placed implants seem to be similar to implants inserted delayed or late, esthetic failures with midfacial and interproximal loss of soft tissue volume seem to be a common finding. To decrease the extent of soft tissue deficiencies in post-extraction sites, a variety of clinical recommendations as well as alveolar ridge preservation techniques have been described and investigated in the literature showing a significant reduction in vertical and horizontal defect formation following tooth extraction compared to unassisted socket healing. However, systematic literature reviews come invariably to the conclusion, that post-extraction resorption of the alveolar ridge might be limited, but cannot be completely avoided.
If therefore the target was, that in the future more implant patients can benefit from immediate implant placement, preventing loss of periodontal ligament and bundle bone after tooth removal would be key. In this connection “Root Retention” has currently attracted a renewed and increasing interest as “Root Submergence Technique” for pontic site development and as “Socket Shield Technique” for immediate implant placement. The underlying idea can be simply described as follows: if the root with its periodontal attachment apparatus is retained in the socket, the bundle bone can be preserved and consequently defect formation avoided. Under these circumstances predictable esthetic outcomes may be expected without any additional augmentation procedures and independent of the presence or dimension of the buccal bone plate. In addition to it, previously unattainable esthetic results may be derived in complex situations, in particular if more than one tooth next to each other needs to be replaced.
This two-day seminar provides in-depth instruction in the essential scientific background information to make the right decisions in the individual case for or against partial root retention. Well-supervised hands-on training and carefully selected live surgeries will help you to effectively practice and internalize the essential clinical steps involved in socket-shield interventions according to the currently developed rules of practice.
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This marked the launch of a series of meetings to be held once every three years. The idea is to give our alumni classes from different years the opportunity to network with others and exchange news and information about innovative trends and developments in the field of dentistry. We will hold regular three-day alumni meetings in the seclusion of an alpine resort in Spitzingsee, in the heart of Upper Bavaria. Technically, this is neither a scientific congress nor a practical training course. Instead, our alumni meetings are designed as an institution-based platform to facilitate the eye-level exchange of ideas on current topics among highly qualified colleagues. We also aim to provide updates for specialists on new trends and developments in patient management at these events.
Last but not least, alumni meetings provide the perfect setting to cultivate international relations, build networks and, above all, to meet up with good friends again!
The next Hürzeler/Zuhr Alumni Meeting will be from 2. - 4. July 2020. Further information will be provided in the near future.
